Individual provider Active NPI

Stephen R Bjorklund, DDS

  • General Practice Dentistry
  • Wayzata, MN
National Provider Identifier
1093743312
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8251 Issued in MN
Practice address
250 Central Ave N
111
Wayzata, MN 55391-1206
Phone
(952) 475-1997
NPI assigned
Jun 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8251 MN Primary

Addresses

Primary practice location

250 Central Ave N
111
Wayzata, MN 55391-1206

Mailing address

250 Central Ave N
111
Wayzata, MN 55391-1206
Phone (952) 475-1997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093743312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CENTRAL AVE N",
            "address_2": "111",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911206",
            "telephone_number": "952-475-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CENTRAL AVE N",
            "address_2": "111",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911206",
            "telephone_number": "952-475-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJORKLUND",
        "first_name": "STEPHEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayzata, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.